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ARCHIVED REPORTS_XR0008455
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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4344
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2900 - Site Mitigation Program
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PR0541976
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ARCHIVED REPORTS_XR0008455
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Entry Properties
Last modified
10/10/2020 10:24:08 PM
Creation date
7/9/2020 9:47:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008455
RECORD_ID
PR0541976
PE
2960
FACILITY_ID
FA0024090
FACILITY_NAME
CHEVRON FACILITY #9-9840
STREET_NUMBER
4344
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
10102157
CURRENT_STATUS
01
SITE_LOCATION
4344 WATERLOO RD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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vnmwi wr Lu7lVuv lhumlwl IVU91 <br /> jgmhkChevron Products Com an s 145 S. State Coll oulevard ■ Brea, CA 92822-2292 COC of <br /> Chevron Sitgw Chevron Consultant Secor <br /> r(f� I ANALYSES REQUIRED <br /> Chevron Site Address -+ Ci41c� �� Address e, Specie!Instructions❑ <br /> Consultant Contact 5c��,c, (,� ❑ <br /> 8 <br /> Consultant Phone No ���- ,� o`f _ W ❑ <br /> Chevron PM .� ° 4�X <br /> q Consultant Protect No 077< < 55)7,25A o z oChevron PM Phone No _.CI[,- � ' C7y Sampling Company _� �CB�. _ Q o a o �� C�4tiw <br /> Sampled By(Punt) &'.' co t4 4 <br /> p am " <br /> Sampler Signature _-/1� ,� _ z 4a <br /> Chevron Service Code ZZ02800 Laboratory o ❑ 2 UJ0 �'W OP �(�P <br /> ElConstruction/Retail Job or <br /> mLaboratory Address iZSS( <br /> t Sp�4�7 r m m o <br /> ❑Site Assessment and Remediation (SAR) Job _ ❑ Y U <br /> U <br /> Lab Contact „w �fGr.,�•r7 _ d LL o ❑ <br /> NOTE: h m a o a a F <br /> THIS!SALEGAL DOCUMENT. ALLFIELDS MUST Lab Phone No _ %00-�'�3� �1�� m m co o <br /> o � m <br /> BE FILLED OUT CORRECTL Y Arun COMPLETEL Y S co w w T � C °° <br /> 00 <br /> aa ¢ acli <br /> LU w w w W w N LU <br /> Sample Sample Container #OfSampling Date/ Preservation Notes/Comments <br /> Description Matrix Type Containers Time <br /> i -7 s1 �al <br /> } <br /> ` S" <br /> - <br /> Rel wish�11 �Qompany Date/Time R V�r Company <br /> Date/Time Turnaround Time <br /> 24 Hours Standard <br /> RelinquisheyCompany Date�me elinquished Co pang Date/Time <br /> 48 hours Other <br /> anSample Integrity (Check by lab) <br /> Relinquished By Com <br /> any y DatelTime 4Reegwshe o Company at /Time <br /> Intact On ice <br /> Chevron COC Revision 2 April 10,2001 <br />
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